Prolonged use of nomegestrol acetate and risk of intracranial meningioma: a population-based cohort study

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作者
Nguyen, Pierre [1 ]
Roland, Noemie [1 ,8 ]
Neumann, Anke [1 ]
Hoisnard, Lea [2 ]
Passeri, Thibault [3 ]
Duranteau, Lise [4 ]
Coste, Joel [5 ,6 ]
Froelich, Sebastien [3 ]
Zureik, Mahmoud [1 ,7 ]
Weill, Alain [1 ]
机构
[1] EPI PHARE Sci Interest Grp, French Natl Agcy Safety Med & Hlth Prod & French N, St denis, France
[2] Paris Est Creteil Univ UPEC, EpiDermE Epidemiol Dermatol & Evaluat Therapeut, EA7379, Creteil, France
[3] Univ Paris, Lariboisiere Hosp, AP HP, Dept Neurosurg, Paris, France
[4] Paris Saclay Univ, Bicetre Hosp, AP HP, Dept Med Gynaecol, F-94270 Le Kremlin-bicetre, France
[5] Cochin Hosp, AP HP, Biostat & Epidemiol Unit, Paris, France
[6] Paris Cite Univ, Paris, France
[7] Versailles St Quentin Yvelines Univ, Montigny le Bretonneux, France
[8] EPI PHARE, ANSM, 143-147 Blvd Anatole France, F-93285 St Denis, France
来源
关键词
Meningioma; Progestin; Nomegestrol acetate; Pharmacoepidemiology; REPRODUCTIVE FACTORS; HORMONE USE; GLIOMA;
D O I
10.1016/j.lanepe.2024.100928
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Nomegestrol acetate (NOMAC) is a synthetic potent progestogen. This study aimed to assess the risk of intracranial meningioma associated with the prolonged use of NOMAC. Methods Observational cohort study using SNDS data (France). Women included had >= one dispensing of NOMAC between 2007 and 2017 (no dispensing in 2006). Exposure was defined as a cumulative dose >150 mg NOMAC within six months after first dispensing. A control group of women (cumulative dose <= 150 mg) was assembled. The outcome was surgery (resection or decompression) or radiotherapy for one or more intracranial meningioma(s). Poisson models assessed the relative risk (RR) of meningioma. Findings In total, 1,060,779 women were included in the cohort (535,115 in the exposed group and 525,664 in the control group). The incidence of meningioma in the two groups was 19.3 and 7.0 per 100,000 person-years, respectively (age-adjusted RRa = 2.9 [2.4-3.7]). The RRa for a cumulative dose of more than 6 g NOMAC was 12.0 [9.9-16.0]. In the event of treatment discontinuation for at least one year, the risk of meningioma was identical to that in the control group (RRa = 1.0 [0.8-1.3]). The location of meningiomas in the anterior and middle part of the skull base was more frequent with exposure to NOMAC. Interpretation We observed a strong dose-dependent association between prolonged use of NOMAC and the risk of intracranial meningiomas. These results are comparable to those obtained for cyproterone acetate, although the magnitude of the risk is lower. It is now recommended to stop using NOMAC if a meningioma is diagnosed. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
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页数:11
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